Usefulness of TC-99M GSA liver scintigraphy for the assessment of recurrent hepatitis C after living-donor liver transplantation: a case report.
OBJECTIVE
Recurrence of hepatitis C after living-donor liver transplantation was investigated using technetium-99m-diethylenetriaminepentaacetic acid-galactosyl human serum albumin (Tc-99m-GSA) liver scintigraphy.


METHODS
A 55-year-old woman with cirrhosis due to chronic hepatitis C virus (HCV) infection underwent liver transplantation with a graft from her husband. Scintigraphy was used to determine the hepatic uptake ratio of the tracer corrected for disappearance from the blood, as well as the maximal removal rate of the tracer by hepatocytes, as parameters of hepatic functional reserve.


RESULTS
Conventional liver function parameters and the graft volume (computed tomography) were almost unchanged up to 18 months after transplantation. Serum HCV RNA was elevated from 3 months after transplantation, and was twofold higher at 12 months compared with 6 months. At 18 months postoperatively, liver biopsy showed an increase of histologic activity, and there was also evidence of recurrent hepatitis C. The corrected hepatic uptake ratio and maximal removal rate were decreased at 3 months postoperatively, and thereafter remained low.


CONCLUSIONS
The decrease of scintigraphic parameters at 3 months after transplantation suggested recurrent hepatitis C affecting the graft. Tc-99m-GSA liver scintigraphy is a useful noninvasive method for evaluating graft functional reserve.
Kaibori
M
M
Department of Surgery, Kansai Medical University, Osaka, Japan. kaibori@hirakata.kmu.ac.jp
Ha-Kawa
S-K
SK
Kamiyama
Y
Y
D005260:Female; D006526:Hepatitis C / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008111:Liver Function Tests; D016031:Liver Transplantation; D019520:Living Donors; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012008:Recurrence; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate